WVC 25 - 1 - 4
§25-1-4. Limitation on reimbursement rate to medical service
providers for services outside division facilities.
(a) Effective the first day of July, two thousand seven, the
division, or its contracted medical provider, may not pay an amount
to an outside provider of a medical service for a person residing
in a correctional facility greater than seventy-three percent of
the billed charges: Provided, That critical access hospitals shall
be reimbursed at eighty-five percent of the billed charges. This
limitation applies to all medical care services, goods,
prescription drugs and medications provided to a person who is in
the custody of a correctional facility and is provided these
services outside of said correctional facility.

(b) Effective the first day of July, two thousand eight, the
division, or its contracted medical providers, may not pay an
amount to an outside provider of a medical service for a person
residing in a correctional facility greater than the reimbursement
rate applicable to service providers established by legislative
rule of the Bureau for Medical Service within the Department of
Health and Human Resources: Provided, That critical access
hospitals shall be reimbursed at seventy-five percent of the billed
charges. These limitations apply to all medical care services,
goods, prescription drugs and medications provided to a person who
is in the custody of a correctional facility and is provided these
services outside of a correctional facility: Provided, however,
That the Department of Military Affairs and Public Safety and the Department of Health and Human Resources effectuate an interagency
agreement for the electronic processing and payment of medical
services.

Note: WV Code updated with legislation passed through the 2015 Regular Session
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